Title:Wallet Neuritis – An Example of Peripheral Sensitization
VOLUME: 14 ISSUE: 3
Author(s):Md Abu Bakar Siddiq*, Israt Jahan and SAM Masihuzzaman
Affiliation:Physical Medicine and Rheumatology, Brahmanbaria Medical College, Brahmanbaria, Department of Biochemistry and Biotechnology, University of Science and Technology, Chittagong, Department of Neurology, Chittagong Medical College, Chittagong
Keywords:Wallet neuritis, occupation, peripheral sensitization, long-standing, lower extremity pain, repetitive compression.
Abstract:Background: Wallet neuritis is an example of extra-spinal tunnel neuropathy concerning
sciatic nerve. Its clinical appearance often gets confused with sciatica of lumbar spine origin. Wallet-
induced chronic sciatic nerve constriction produces gluteal and ipsilateral lower extremity pain,
tingling, and burning sensation. It was Lutz, first describing credit-card wallet sciatica in an Attorney,
surfaced on Journal of American Medical Association (JAMA), 1978; however, the condition
has not been well-studied in various other occupations.
Case Summary: In this write-up, we take the privilege of demonstrating wallet neuritis as an example
of peripheral sensitization in three different professionals’ namely specialist doctor, driver,
and banker first time in Bangladesh. All the three patients’ demonstrated aggravated gluteal pain
with radiation on the homo-lateral lower extremity while remained seated on heavy wallet for a
while, fortunately improved discontinuing such stuff with. Alongside radical wallectomy, piriformis
stretching exercise on the affected side had also been recommended and found worthy in
terms of pain relief.
Conclusion: long-standing use of rear pocket wallet may compress and sensitize ipsilateral sciatic
nerve, generating features resembling lumbago sciatica; thereby, remains a source of patients’ misery
and diagnostic illusion for pain physicians as well.
